Prevalence and costs of treating uncomplicated stage 1 hypertension in primary care: a cross-sectional analysis.
dc.contributor.author | Sheppard, James P | |
dc.contributor.author | Fletcher, Kate | |
dc.contributor.author | McManus, Richard J | |
dc.contributor.author | Mant, Jonathan | |
dc.date.accessioned | 2018-09-11T17:33:34Z | |
dc.date.available | 2018-09-11T17:33:34Z | |
dc.date.issued | 2014-10 | |
dc.identifier.issn | 0960-1643 | |
dc.identifier.uri | https://www.repository.cam.ac.uk/handle/1810/280228 | |
dc.description.abstract | BACKGROUND: Treatment for uncomplicated stage 1 hypertension is recommended in most international guidelines but there is little evidence to indicate that therapy is beneficial. AIM: To estimate the prevalence of this condition in an untreated population and the potential costs of initiating therapy in such patients. DESIGN AND SETTING: Cross-sectional study of anonymised patient records in 19 general practices in the West Midlands, UK. METHOD: Data relating to patient demographics, existing cardiovascular disease (CVD), and risk factors (blood pressure and cholesterol) were extracted from patient records. Patients with a blood pressure of 140/90-159/99 mmHg, no CVD, and <20% 10-year cardiovascular risk were classified as having uncomplicated stage 1 hypertension. Missing data were imputed. The prevalence of untreated, uncomplicated stage 1 hypertension was estimated using descriptive statistics and extrapolated using national data. The cost of achieving blood pressure control in this population was examined in a cost-impact analysis using published costs from previous studies. RESULTS: Of the 34 975 patients (aged 40-74 years) in this study, untreated, uncomplicated stage 1 hypertension was present in 2867 individuals (8.2%, 95% confidence interval [CI] = 7.9 to 8.5). This is equivalent to 1 892 519 patients in England and Wales, for whom the additional cost of controlling blood pressure, according to guidelines, was estimated at £106-229 million per annum, depending on the health professional delivering care. CONCLUSION: Untreated, uncomplicated stage 1 hypertension is relatively common, affecting 1 in 12 patients aged 40-74 years in primary care. Current international guidelines and pay-for-performance targets, if followed, will incur significant costs for a patient benefit that is debatable. | |
dc.description.sponsorship | This work forms part of a larger programme on stroke prevention in primary care supported by the National Institute for Health Research (NIHR) (RP-PG-0606-1153). James P Sheppard holds a Medical Research Council Strategic Skills PostDoctoral Fellowship. Richard J McManus holds an NIHR Professorship. The views and opinions expressed are those of the authors and do not necessarily reflect those of the NHS, NIHR, or the Department of Health. | |
dc.format.medium | ||
dc.language | eng | |
dc.publisher | Royal College of General Practitioners | |
dc.rights | Attribution-NonCommercial 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | |
dc.subject | Humans | |
dc.subject | Cardiovascular Diseases | |
dc.subject | Hypertension | |
dc.subject | Antihypertensive Agents | |
dc.subject | Prevalence | |
dc.subject | Cross-Sectional Studies | |
dc.subject | Primary Prevention | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Middle Aged | |
dc.subject | Cost-Benefit Analysis | |
dc.subject | Primary Health Care | |
dc.subject | England | |
dc.subject | Female | |
dc.subject | Male | |
dc.subject | Practice Guidelines as Topic | |
dc.subject | General Practice | |
dc.title | Prevalence and costs of treating uncomplicated stage 1 hypertension in primary care: a cross-sectional analysis. | |
dc.type | Article | |
prism.endingPage | e648 | |
prism.issueIdentifier | 627 | |
prism.publicationDate | 2014 | |
prism.publicationName | Br J Gen Pract | |
prism.startingPage | e641 | |
prism.volume | 64 | |
dc.identifier.doi | 10.17863/CAM.27595 | |
dcterms.dateAccepted | 2014-05-30 | |
rioxxterms.versionofrecord | 10.3399/bjgp14X681817 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2014-10 | |
dc.contributor.orcid | Mant, Jonathan [0000-0002-9531-0268] | |
dc.identifier.eissn | 1478-5242 | |
rioxxterms.type | Journal Article/Review | |
cam.issuedOnline | 2014-09-29 |
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